An estimated 30 million Americans are expected to gain health insurance through the Affordable Care Act (ACA), and a healthy, sizable workforce will be necessary to meet the increased demand. The health care workforce is already facing a critical shortfall of health professionals over the next decade. The ACA breaks the promises of access and quality of care for all Americans by escalating the shortage and increasing the burden and stress on the already fragile system. With the ACA’s estimated annual 190 million hours of paperwork burden for businesses and the health care industry, on top of worker shortages, patients will face increasing wait times, limited access to providers, and decreased satisfaction. A major redesign of the workforce is needed to extend care to millions of Americans.